Dataset Information

Post-treatment stability after 5 years of retention with vacuum-formed and bonded retainers-a randomized controlled trial.

ABSTRACT:

Background

Retention after orthodontic treatment is still a challenge and more evidence about post-treatment stability and patients' perceptions of different retention strategies is needed.

Objectives

This trial compares removable vacuum-formed retainers (VFR) with bonded cuspid-to-cuspid retainers (CTC) after 5 years of retention.

Trial design

A single centre two-arm parallel-group randomized controlled trial.

Methods

This trial included 104 adolescent patients, randomized into two groups (computer-generated), using sequentially numbered, opaque, and sealed envelopes. All patients were treated with fixed appliances in both jaws with and without tooth extractions. Patients in the intervention group received a VFR in the mandible (n = 52), and patients in the active comparator group received a CTC (n = 52). Both groups had a VFR in the maxilla. Dental casts at debond (T1), after 6 months (T2), after 18 months (T3), and after 5 years (T4) were digitized and analysed regarding Little's Irregularity Index (LII), overbite, overjet, arch length, and intercanine and intermolar width. The patients completed questionnaires at T1, T2, T3, and T4.

Results

Post-treatment changes between T1 and T4 in both jaws were overall small. In the maxilla, LII increased significantly (median difference: 0.3 mm), equally in both groups. In the mandible, LII increased significantly in the group VFR/VFR (median difference: 0.6 mm) compared to group VFR/CTC (median difference: 0.1 mm). In both groups, overjet was stable, overbite increased, and arch lengths decreased continuously. Intercanine widths and intermolar width in the mandible remained stable, but intermolar width in the maxilla decreased significantly. No differences were found between groups. Regardless of retention strategy, patients were very satisfied with the treatment outcome and their retention appliances after 5 years.

Limitations

It was not possible to perform blinded assessments of digital models at follow-up.

Conclusions

Post-treatment changes in both jaws were small. Anterior alignment in the mandible was more stable with a bonded CTC retainer compared to a removable VFR after 5 years of retention. Patients were equally satisfied with fixed and removable retention appliances.

Trial registration

ClinicalTrials.gov (NCT03070444).

SUBMITTER: Kramer A

PROVIDER: S-EPMC9912701 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Post-treatment stability after 5 years of retention with vacuum-formed and bonded retainers-a randomized controlled trial.

Krämer Anke A Sjöström Mats M Apelthun Catharina C Hallman Mats M Feldmann Ingalill I

European journal of orthodontics 20230201 1

<h4>Background</h4>Retention after orthodontic treatment is still a challenge and more evidence about post-treatment stability and patients' perceptions of different retention strategies is needed.<h4>Objectives</h4>This trial compares removable vacuum-formed retainers (VFR) with bonded cuspid-to-cuspid retainers (CTC) after 5 years of retention.<h4>Trial design</h4>A single centre two-arm parallel-group randomized controlled trial.<h4>Methods</h4>This trial included 104 adolescent patients, ran ...[more]

PMID: 35968668

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Project description:BackgroundMaxillary bonded and removable retainers maintain teeth in correct positions following orthodontic treatment. There is insufficient evidence regarding the capacity of the retention methods to stabilize the maxillary teeth both during and after retention.ObjectiveTo evaluate retention capacity and 1-year post-retention changes in the irregularity of maxillary anterior teeth and single anterior tooth contact point discrepancy (CPD) of two bonded and one removable retention method.Trial designThree-arm parallel group single-centre randomized controlled trial.MethodsNinety adolescent patients treated with fixed orthodontic appliances were enrolled. After gaining informed consent, the patients were randomized in blocks of 30 by an independent person into one of three groups: A) bonded retainer 13-23; B) bonded retainer 12-22; and C) removable vacuum-formed retainer. The primary outcomes were changes in Little's irregularity index (LII) and single CPD measured on digitalized casts before retention (T1), after 2 years of retention (T2), and 1-year post-retention (T3).BlindingThe digital casts were blinded for the outcome assessor.ResultsData on all 90 patients were analysed according to intention-to-treat principles. Changes in LII during retention were 0.3 mm in group A, 0.6 mm in group B, and 1.0 mm in group C. No significant differences between the groups were seen (P > 0.05). Changes during post-retention were 1.1 mm in group A, 0.5 mm in group B, and 0.4 mm in group C. Group A showed more significant changes than groups B and C (P = 0.003). During the whole post-treatment period, no significant differences were shown between the groups (P > 0.05). CPD did not differ significantly between the groups at any point.HarmsThree patients showed changes of LII over 3 mm or CPD over 2 mm during the post-retention period, and two accepted to be realigned.LimitationsThe trial was a single-centre study evaluating 1-year post-retention changes.ConclusionsThe changes were clinically insignificant during and after the retention period. Thus, all three methods showed equal retention capacity.Trial registrationwww.clinicaltrials.com (NCT04616755).

Project description:ObjectivesTo compare the clinical effectiveness of Hawley retainers (HRs) and modified vacuum-formed retainers (mVFRs) with palatal coverage in maintaining transverse expansion throughout a 24-month retention period and to assess the subjects' perception toward the retainers.Materials and methodsThe trial accomplished blinding only by the outcome assessor and data analyst. Data were collected from post-orthodontic treatment patients who met the inclusion criteria. Thirty-five subjects were randomly allocated using a centralized randomization technique into either mVFR (n = 18) or HR group (n = 17). Dental casts of subjects were evaluated at debond (T0), 3-month (T1), 6-month (T2), 12-month (T3), and 24-month retention (T4). The intercanine width (ICW), interpremolar width (IPMW), interfirst molar mesiobuccal cusp width (IFMW1), and interfirst molar distobuccal cusp width (IFMW2) were compared between groups over time using Mixed ANOVA. A pilot-tested and validated questionnaire consisting of six items were given at T4. Subjects were instructed to rate their retainer in terms of fitting, speech, appearance, oral hygiene, durability, and comfort on a 100-mm Visual Analogue Scale (VAS).ResultsNo statistically significant differences in arch width were found between the two groups at ICW (P = .83), IPMW (P = 0.63), IFMW1 (P = .22), and IFMW2 (P = .46) during the 24-month retention period. Also, no statistically significant differences were found between perception of both retainers in terms of fitting, speech, oral hygiene, durability, and comfort (P > .05) after 24-month wear. The appearance of mVFRs was rated significantly higher compared to HRs (P < .05).ConclusionsHR and mVFR have similar clinical effectiveness for retention of transverse expansion cases in a 24-month retention period. Both retainers were perceived to be equal in terms of fitting, speech, oral hygiene, durability, and comfort. Subjects in the mVFRs group found their retainers to be significantly more esthetic than those in HRs group.

Project description:BackgroundRecently, increasing attention has been paid to the periodontal health of orthodontic patients in the maintenance stage in clinical practice. The focus of this meta-analysis was to compare the effects of vacuum-formed retainers (VFR) and Hawley retainers (HR) on periodontal health, in order to provide a reference for clinical selection.MethodsFrom the establishment of the database until November 2020, a large number of databases were searched to find relevant randomized control trials, including the Cochrane Library databases, Embase, PubMed, Medline via Ovi, Web of Science, Scopus, Grey Literature in Europe, Google Scholar and CNKI. Related literature was manually searched and included in the analysis. Two researchers screened the literature according to relevant criteria. The size of the effect was determined using RevMan5.3 software, and the mean difference and 95% confidence intervals (CI) were used to estimate the results using a random effects model.ResultsThis meta-analysis included six randomized controlled trials involving 304 patients. The results of the meta-analysis showed that there was no statistical difference in sulcus probing depth status between the VFR group and the HR group, including at 1, 3, and 6 months. Compared with the VFR group, the HR group showed a lower gingival index at 1 month (mean difference = 0.12, 95%CI: 0.06 to 0.19) and 3 months (mean difference = 0.11, 95%CI: 0.06 to 0.17), while there was no statistically significant difference at 6 months (mean difference = 0.10, 95%CI: -0.07 to 0.27). The plaque index of the HR group also showed a good state at 1 month (mean difference = 0.06, 95%CI: 0.01 to 0.12), 3 months (mean difference = 0.12, 95%CI: 0.08 to 0.16), and 6 months (mean difference = 0.19, 95%CI: 0.09 to 0.29). Subgroup analysis of PLI showed that when all teeth were measured, PLI status was lower in the HR group at 6 months (mean difference = 0.32, 95%CI: 0.18 to 0.46). PLI status was also low for the other teeth group (mean difference = 0.15, 95%CI: 0.08 to 0.22).ConclusionOur meta-analysis showed that patients using the Hawley retainer had better periodontal health compared with those using vacuum-formed retainers. However, more research is needed to look at the periodontal health of patients using these two retainers.

Dataset Information

Post-treatment stability after 5 years of retention with vacuum-formed and bonded retainers-a randomized controlled trial.

Background

Objectives

Trial design

Methods

Results

Limitations

Conclusions

Trial registration

Publications

Post-treatment stability after 5 years of retention with vacuum-formed and bonded retainers-a randomized controlled trial.

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